Doctors are expected not just to diagnose and treat diseases but to prevent disease by counseling patients about behaviors that expose them to risk.  We are expected to ask patients about smoking, alcohol use, high-risk sexual behavior, failure to use seatbelts and dancing on windowsills.  We are expected to counsel our patients to refrain from behaviors that may lead to injury or disease.

“Mrs. Jones, I’m very worried about the fact that you grease your stairs with motor oil.  I advise that you stop.”

To the list of dangerous behaviors we should be asking our patients about, we now must add distracted driving.  A perspective article in this week’s New England Journal of Medicine argues eloquently that distracted driving due to cell phone use is a major cause of preventable injury and death, and that physicians have a duty to warn and educate patients about it.

It’s important to note that this is a perspective article, similar to an op-ed piece, and not a scientific paper.  The science here is quite thin, but no ethical randomized trial can be imagined in which drivers are assigned to an attentive or a distracted group and then broken bones are tallied.  The few observational studies available suggest that distracted driving impairs drivers about as much as alcohol intoxication.

Though texting while driving is obviously dangerous, the author argues that even talking on the phone hands-free is distracting and keeps drivers from focusing all their attention on the task at hand.  She argues that talking on a cell phone is much more impairing than listening to the radio or talking with a passenger.

The data, though, is fuzzier.  A study from Virginia Tech (see link below) used video cameras in actual cars and trucks and observed drivers over more than 6 million miles.  They correlated driver behavior with the risk of a crash or a near crash.  They conclude that

Driving is a visual task and non-driving activities that draw the driver’s eyes away from the roadway, such as texting and dialing, should always be avoided.  “Headset” cell phone use is not substantially safer than “hand-held” use, because the primary risk associated with both tasks is answering, dialing, and other tasks that require your eyes to be off the road.  In contrast, “true hands-free” phone use, such as voice activated systems, are less risky if they are designed well enough so the driver does not have to take their eyes off the road often or for long periods.

So just don’t text while driving, and don’t read that text that you just received.  And if you have to dial to make a call, consider waiting until you arrive at your destination.  And remind me to ask you about this at your next annual exam.

Fortunately, I ride my bike to work.  But maybe I should find a different time to do Sudoku.

Learn more:

Reuters article:  Doctors urged to warn against cellphone use in cars

US Department of Transportation official website for distracted driving:

New England Journal of Medicine perspective article:  The Most Primary of Care — Talking about Driving and Distraction

Virginia Tech Transportation Institute article:  New Data from VTTI Provides Insight into Cell Phone Use and driving Distraction

Tangential miscellany:

In the interests of full disclosure, this is a shameless plug for my esteemed colleague, friend and neighbor, Dr. Jonathan Corren, who is also a terrific allergist.  His new book 100 Questions & Answers about Allergies was just published and offers a comprehensive guide to allergy diagnosis and management written for patients.  I haven’t read it yet, but when I do, I’ll review it here.

Finally, medical news posting will be on hiatus for two weeks and will resume July 2.